The Capgras Delusion: History, Causes, and Treatments

Capgras delusion is a rare mental disorder where a patient believes that a close relative, usually a spouse, is disguised as an impostor. This particular disorder is a delusional misidentification syndrome, a classification of mental disorders which involves wrong identification of objects, places, or people.

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Symptoms:

A person with Capgras syndrome has this strong belief that the person close to him or her is being replaced by an impostor who looks exactly the same, like a double. The person may also see animals, objects as doubles. He may even see himself as a double. Unlike in hallucinations, the person is aware of these abnormalities in his perception. Another significant characteristic in the Capgras syndrome is that this ‘double’ seen by the person affected is usually a key figure in his life, often a spouse, a partner, or a best friend.

A person with the condition may also be seen straying from other people. Other signs and symptoms that may occur in a person with Capgras syndrome include seizures or epilepsy attacks and hysteria.

History:

‘Capgras’ in Capgras syndrome was taken from the name of the French psychiatrist who first described the condition, Jean Marie Joseph Capgras. In 1923, Joseph Capgras, along with Jean Reboul-Lachaux, wrote in his paper the description of the Capgras syndrome, which wasn’t called as such then. At that time, the condition was referred to as ‘l’illusion des sosies,’ which literally means ‘illusion of doubles.’

In his paper, Joseph Capgras described the condition of a French psychiatric patient with a complaint of seeing ‘doubles’ of her husband and other people she knew, specifically saying that a double had taken over her husband’s place. The illusion of seeing ‘doubles’ or ‘look-alikes’ was often noted as a form of hysteria to those suffering from schizophrenia.

It was in the late 1980s, however, when researches arrived at the present knowledge that the Capgras syndrome is associated with an organic lesion in the brain.

Causes:

The part of the brain affected in Capgras syndrome is the occipital lobe which possesses the brain functions related to vision and memory. Although the cause of Capgras is mainly attributed to this organic lesion in the occipital lobe where face recognition is majorly affected, there are other risk factors contributing to its development.

The following are the different factors which can play roles in causing Capgras delusion:

Dementia

Oedipus/Electra complex

Schizophrenia

Epilepsy

Alzheimer’s disease

Brain damage due to:

Stroke

Drug overdose

Traumatic injury

Repressed feelings

Other health conditions such as hypothyroidism, migraine, and diabetes are also associated with the Capgras syndrome. The condition is more prevalent in women than in men.

Treatment:

Capgras syndrome cannot be completely cured. Its treatment only involves relieving it symptoms through cognitive and pharmacological therapies.

Some cognitive-behavioral therapy techniques used for Capgras syndrome include reframing and reality testing. Pharmacotherapy with antipsychotic medications is also effective in treating the disorder especially if used along with the cognitive therapy. Drugs used for treatment of Capgras delusion include pimozide, clozapine, and risperidone.